Zhuangzi and Depression: Toward a Culturally Informed Conceptual Framework for Integrative Psychotherapy

Depression is a major contributor to global disability, yet symptom reduction alone does not exhaust the clinical problem of meaning, self-interpretation, and cultural fit in treatment [1][2]. This article develops a conceptual review of how Zhuangzi's philosophy may inform integrative psychotherapy for depression. Through close reading of recurrent Zhuangzi themes and a focused synthesis of literature on cognitive therapy, mindfulness-based cognitive therapy, Acceptance and Commitment Therapy, Morita Therapy, and cultural psychiatry, the paper identifies three clinically relevant constructs: decentering from rigid self-identification, acceptance of change and limited control, and reconstruction of value beyond instrumental achievement. The analysis argues that Zhuangzi should not be treated as a stand-alone treatment or as an empirical substitute for evidence-based care. Rather, it can function as a culturally resonant interpretive framework, especially in contexts where patients struggle with rumination, perfectionism, and performance-contingent self-worth. The paper concludes by outlining a cautious agenda for theoretically grounded and culturally responsive integration.